Individual provider · NPI-1

Michele A. De La Cruz, MHS, MPP,PhD

Counselor · Mableton, GA

NPI number1679282271
StatusActive
Last updated in NPPESFeb 7, 2024

Details

NPI
1679282271
Entity type
Individual (NPI-1)
Name
Mrs. Michele A. De La Cruz
Credential
MHS, MPP,PhD
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 22, 2022
Certification date
Feb 6, 2024
Last updated
Feb 7, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101Y00000X Counselor5225NJYes

Practice location

6969 Gallant Cir Se
Mableton, GA 30126-4683

Phone 229-443-5190

Mailing address

6969 Gallant Cir Se
Mableton, GA 30126-4683

Phone 229-443-5190

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